What is the “avoidance personality disorder”, how is it formed, how to judge and respond?

What is the "avoidance personality disorder", how is it formed, how to judge and respond?

What we know about “avoidance behavior” in interpersonal interactions usually begins in infants or children, accompanied by shyness, isolation, and fear of strangers and new environments. For most people, this performance tends to fade away with age, which is a normal phenomenon.

In contrast , individuals who develop avoidant personality disorder may become more shy and avoidable during adolescence and early adulthood, when social relationships with new people become especially important. Of course, after adulthood, everyone’s demand for social activities is different, and the tendency to avoid occasional, minor or specific situations is universal and normal.

What is the "avoidance personality disorder", how is it formed, how to judge and respond?
What is the “avoidance personality disorder”, how is it formed, how to judge and respond?

So, what is the “avoidance personality disorder”?

In the book The Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-5), edited by the American Academy of Psychiatry, the avoidance personality disorder is defined as a social inhibition, lack of self-perception and negative Sexual evaluation of extremely sensitive patterns of psychological behavior.

Although childhood shyness is a common prelude to avoidive personality disorder, determining a person’s avoidance personality disorder requires more diagnostic criteria . The diagnostic criteria and diagnostic characteristics of DSM-5 can be summarized as follows: Individuals exhibit 4 or more of the following symptoms :

1. Avoid professional activities involving more interpersonal contact because of fear of criticism, denial or exclusion.

2. Reluctant to deal with people and not willing to make new friends unless they are determined to be liked and accepted without criticism.

3. Interpersonal intimacy is often difficult for them: although individuals can establish intimate relationships when they confirm acceptance without criticism, they are still intimate because they are shy or afraid to be exposed, ridiculed, and humiliated. The relationship is cautious and it is difficult to talk about itself.

4. Because they have preemptive ideas that are criticized or rejected in social situations, they may have a particularly low threshold for discovering these reactions. Even if the disapproval or criticism of others is extremely slight, they will feel very hurt. These individuals have a strong reaction to clues that suggest irony or ridicule. Because they expect that no matter what they say, others will think it is wrong, so they tend to say nothing.

5. Because of the lack of individual feeling ability and low self-esteem, it appears to be cautious in the case of new interpersonal relationships.

6. Think that you are clumsy in social terms, lacking personal appeal or inferiority . Especially in the dealings with strangers, their doubts and concerns about their social skills and personal charisma are particularly obvious.

7. It is for the above reasons that the individual is very reluctant to take personal risks or participate in any new activities because it may be embarrassing. They can easily exaggerate potential threats under normal circumstances, and excessive demand for certainty and security may also limit their living habits.

It should be noted that people of different cultures and ethnicities believe that the degree of distrust and avoidance is appropriate and may be different. In the diagnosis, individual cultural differences need to be considered, and it is also necessary to judge whether the avoidance behavior is the result of cultural adaptation problems caused by migration.

How is the avoidance personality disorder formed?

First, avoidance personality disorder is related to heredity. Ted Reichborn-Kjennerud and Nikolai Czajkowski et al. (2007) found that the genetic susceptibility of avoidant personality disorder and social phobia is the same by studying female twins, and what obstacles are developed by people carrying related genes, More related to its specific environmental factors.

Among these specific environmental factors, early emotional disregard is particularly important . Cognitive theorists suggest that individuals with avoidance personality disorder develop beliefs about dysfunction and believe that they have no value. This is the result of rejection by important others in early life . They argue that children who are rejected by their parents will come to the conclusion: “If my parents don’t like me, who else would like me?” So they avoided talking to others. Their idea is this: “Once people know me, they will find that I am really bad.” When they have to communicate with other people, they will become unconfident and nervous, thinking: “I must be Always please the other side, or she will criticize me.” They also tend to underestimate the positive feedback they get from others, thinking that others are just out of courtesy, or have not found how incompetent they are (Beck & Freeman, 1990) ).

How to deal with avoidance personality disorder?

If you just evade or dislike social interaction, you can make appropriate adjustments to your work and life. When your life and work are seriously affected, the first thing we need to do is to go to a professional organization for diagnosis.

At present, cognitive behavioral therapy (CBT) has been shown to be helpful for avoidance personality disorder. These treatments include exposing the patient to a social environment, conducting social skills training, and questioning the individual’s negative automatic thinking about themselves and social situations. People who receive these treatments increase their social frequency, expand their social reach, reduce their avoidance behavior, and increase their comfort and satisfaction when participating in social activities.

In the treatment of drugs, serotonin reuptake inhibitors are sometimes used to reduce social anxiety in patients with avoidable personality disorder, but there are few studies on the treatment of avoidance personality disorder.

Reference materials:

  • Beck, AT, Davis, DD, & Freeman, A. (Eds.). (2015). Cognitive therapy of personality disorders. Guilford Publications.
  • Reichborn-Kjennerud, T., Czajkowski, N., Torgersen, S., Neale, MC, Ørstavik, RE, Tambs, K., & Kendler, KS (2007). The relationship between avoidant personality disorder and social phobia: a population -based twin study. American Journal of Psychiatry, 164(11), 1722-1728.
  • Ripoll, LH, Triebwasser, J., & Siever, LJ (2011). Evidence-based pharmacotherapy for personality disorders. International Journal of Neuropsychopharmacology, 14(9), 1257-1288.
  • American Academy of Psychiatry. (2015). Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition). Peking University Press
  • Susan Noron-Hochsimma. (2017). Abnormal Psychology. People’s Posts and Telecommunications Press.
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